IMPACT OF CENTRAL VENOUS PRESSURE AND DIURESIS ON RENAL GRAFT FUNCTION

Abstract

Introduction: Renal graft function in the immediate posttransplant period is directly associated with patients hemodynamic condition during graft revascularization and early postoperative period. Our aim was to evaluate correlation between average daily value of central venous pressure (CVP) and renal perfusion, in first seven posttransplant days.

Patients and methods: We recruited 74 patients, who underwent renal transplantation. We evaluated the influence of CVP and 24 h urine output on renal graft function. In order to assess the renal graft function, following parameters were evaluated: glomerular filtration rate (GFR), creatinine clearance, 24-hour urine output, and from the serum levels of K+, Na++, urea and creatinine.

Results: Statistically significant positive correlation between mean values of CVP and 24 h urine output was found on the first (r=0.5422; p=0.0001) but not on the third postoperative day (r=0.1116; p=0.344). Statistically significant inverse correlation between mean values of creatinine and diuresis was found on the first (r=-0.2824; p=0.015) and third (r=-0.2976; p=0.01) postoperative day but on the seventh postoperative day a positive statistically significant correlation between these parameters was registered (r=0.4114; p=0.0001). There is a statistically significant difference between GFR and urine output on the first (r=0.2771; p= 0.017) and seventh day (r=0.4114; p=0.0001). We have not found any significant correlation between mean values of creatinine clearance and diuresis on the first posttransplant day (r=0.1760; p=0.134), but when same parameters were examined on the seventh day a positive statistical significance was found (r=0.4248; p=0.0001).

Conclusion: Renal graft survival in early postoperative period is largely influenced by recipient hemodynamic condition. This study proved that 24-hour urine output directly depended on CVP level; it also proved existence of statistically significant correlation between mean values of diuresis, creatinine clearance, GFR and serum creatinine.